Margin Status Influence on the Outcome of Patients Treated with Breast Conserving Surgery

Abstract

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Background: Breast conserving surgery (BCS) followed by local radiotherapy is the standard treatment for early stage of breast cancer. Margin status may have an important impact on local recurrence and overall survival of patients treated with BCS, but this has not been defined adequately. In this study, we investigated the relationship between microscopic margins and outcome of BCS.

Methods: Three hundred eighty four patients treated with BCS between 1999 and

2010 were included in our study. All surgeries were performed by a single surgical team. Margins were defined as close if surgical margins were less than 2 mm, as free if surgical margins were more than 2 mm and as positive if malignant cells were present in one of the tissue edges. Demographic, clinical, and pathological factors as well as biological markers, recurrence, and survival rates were compared between the close and the free margins groups.

Results: The mean age of patients at the time of diagnosis was 54.2 years. There were 34 (9%) recurrence cases and overall survival was 128.7 months and ten years survival rate was 81%. There was no significant difference between the close and the free margins groups in terms of demographic parameters, tumor characteristics, biological factors (estrogen and progesterone receptor status) and lymphovascular invasion. Also recurrence rate did not differ significantly between these two groups.

Conclusion: Our study indicates that there is no significant difference between the patients with close and the free margins in terms of treatment results. There is no clear consensus in the surgeons’ community over the definition of acceptable margin width in BCS, so additional studies are required to find the right answer.

P, Evans E, et al. Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet. 2005 Dec 17;